血清BSP、SOST及Ca^2+水平与维持性血液透析患者腹主动脉钙化的关系  

Relationship between serum BSP,SOST,Ca^2+levels and abdominal aortic calcification in patients undergoing maintenance hemodialysis

作　　者：司江涛[1] 崔文军[1] 安乾[1] 王颖[1] 吴斐[1] 李阳[1] 王广华[1] 王梦宇 王兵[1] SI Jiangtao;CUI Wenjun;AN Qian;WANG Ying;WU Fei;LI Yang;WANG Guanghua;WANG Mengyu;WANG Bing(Department of Vascular Surgery,the Fifth Affiliated Hospital of Zhengzhou University,Zhengzhou,Henan,China,450000)

机构地区：[1]郑州大学第五附属医院血管外科,河南郑州450000

出　　处：《分子诊断与治疗杂志》2020年第11期1548-1551,共4页Journal of Molecular Diagnostics and Therapy

基　　金：河南省医学科技攻关计划项目(2019T03014)。

摘　　要：目的探讨维持性血液透析(MHD)患者血清骨唾液酸蛋白(BSP)、骨硬化蛋白(SOST)及Ca^2+水平与腹主动脉钙化的关系。方法选取2018年6月至2020年3月在本院血液净化中心规律行MHD治疗的患者70例,透析时间3个月以上;采用腹部侧位X线片来评估患者腹主血管钙化情况,计算腹主动脉钙化评分(AACs),并根据AACs评分将MHD患者分为无/轻度钙化组(AACs≤4分)和中重度钙化组(AACs>4分);所有病例透析前检测血红蛋白、白蛋白、三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白(LDL-C)、高密度脂蛋白(HDL-C)、糖化血红蛋白、血脂、Ca^2+、磷、骨唾液酸蛋白(BSP)、骨硬化蛋白(SOST)水平。结果 70例MHD患者中,无/轻度钙化组28例(40.00%),中重度钙化组42例(60.00%);无/轻度钙化组和中重度钙化组年龄、透析龄、Ca^2+、磷、BSP、SOST比较,差异有统计学意义(P<0.05);Pearson相关性分析显示,AACs与年龄、透析龄、Ca^2+、磷、BSP及SOST均呈显著正相关(P<0.05);多因素Logistic回归分析提示,透析龄长(OR=1.204,95%CI:1.086-1.336),BSP水平升高(OR=1.445,95%CI:1.073-1.946)及SOST水平升高(OR=2.252,95%CI:1.353-3.749)是MHD患者腹主动脉中重度钙化的独立危险因素(P<0.05)。结论 MHD患者多伴有腹主动脉钙化,透析龄长以及BSP、SOST水平增加是MHD患者腹主动脉中重度钙化的独立危险因素。Objective To explore the relationship between serum bone sialoprotein(BSP),sclerostin(SOST),Ca2+levels and abdominal aortic calcification in patients undergoing maintenance hemodialysis(MHD).Methods Seventy patients who underwent regular MHD in blood purification center in the hospital from June 2018 to March 2020 were enrolled.The abdominal aortic calcification was evaluated by abdominal lateral X-ray films.The abdominal aortic calcification scores(AACs)were calculated.According to different AACs,MHD patients were divided into the non/mild calcification group(AACs not higher than 4 points)and the moderate-severe calcification group(AACs higher than 4 points).The dialysis time was over 3 months.Before dialysis,the levels of hemoglobin,albumin,triglyceride(TG),total cholesterol(TC),lowdensity lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C),glycated hemoglobin,blood lipid,Ca^2+,phosphorus,BSP and SOST were measured and compared.Results Among the 70 patients with MHD,28 cases(40.00%)were in the non/mild calcification group and 42 cases(60.00%)were in the moderate-severe calcification group.The differences in age,dialysis age,Ca^2+,phosphorus,BSP and SOST were statistically significant between the non/mild calcification group and the moderate-severe calcification group(P<0.05).Pearson correlation analysis showed that AACs were significantly positively correlated with age,dialysis age,calcium,phosphorus,BSP and SOST(P<0.05).Multivariate Logistic regression analysis indicated that the age of dialysis(OR=1.204,95%CI:1.086~1.336),increased level of BSP(OR=1.445,95%CI:1.073~1.946)and increased level of SOST(OR=2.252,95%CI:1.353~3.749)were independent risk factors for moderate to severe abdominal aortic calcification in MHD patients(P<0.05).Conclusion MHD patients are mostly accompanied with abdominal aortic calcification.Long dialysis age and increased levels of BSP and SOST are independent risk factors for moderate and severe calcification in MHD patients.

关 键 词：维持性血液透析 腹主动脉钙化 骨唾液酸蛋白 骨硬化蛋白 

分 类 号：R692.5[医药卫生—泌尿科学]